title: Nurse retention: a review of strategies to create and enhance positive practice environments in clinical settings.
abstract: OBJECTIVE
  This paper summarises and critically reviews strategies identified in the literature which support retention of nurses by the creation and enhancement of positive practice environments in the clinical setting.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  A literature search was undertaken in February 2012 of major healthcare-related databases, Cinahlplus, Medline, and Proquest.
  
  
  METHODS
  The keywords "nurs* AND practice AND environment" were used in the first instance. Additional keywords "retention strategies" were also searched. Abstracts were reviewed and articles which potentially outlined strategies were identified. Reference lists were scanned for other potential articles. Articles in languages other than English were excluded. Lake's Practice Environment Scale of the Nursing Work Index provided a framework from which to assess the strategies.
  
  
  RESULTS
  Thirty-nine papers reported strategies for creating a positive practice environment. Only two articles reported on a pre-test post-test evaluation of the proposed strategy. Strategies included: empowering work environment, shared governance structure, autonomy, professional development, leadership support, adequate numbers and skill mix and collegial relationships within the healthcare team.
  
  
  CONCLUSIONS
  Creating positive practice environments enhances nurse retention and facilitates quality patient care. Managers and administrators should assess and manage their practice environments using a validated tool to guide and evaluate interventions.
authors.affiliation: School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia. Electronic address: d.twigg@ecu.edu.au.
authors.forename: Di
authors.initials: D
authors.lastname: Twigg
authors.forename: Kylie
authors.initials: K
authors.lastname: McCullough
mesh_terms: D006801:Humans; D007588:Job Satisfaction; D009740:Nursing Staff; D010558:Personnel Loyalty; D011787:Quality of Health Care
keywords: Nurse retention; Nursing; PES-NWI; Practice environment; Workforce